Miniperc Surgery for Kidney Stones in South Delhi

About Mini Perc

MiniPerc, or Mini Percutaneous Nephrolithotomy, is an advanced minimally invasive technique designed for the removal of small to medium kidney stones (usually 1–2 cm). It uses fine-caliber access sheaths and miniature surgical tools (11–20 Fr) to achieve stone clearance with minimal trauma. 

Compared to conventional PCNL, MiniPerc offers reduced bleeding, faster healing, and shorter hospital stays. It is especially beneficial for patients with renal stones unresponsive to ESWL or medicines, and for stones located in the lower calyx or resistant areas. Its smaller tract makes it particularly advantageous in slim, young, or pediatric patients, ensuring safer and more precise stone management.

Mini Perc Procedure

Step 1:  Anaesthesia: General anaesthesia ensures patient comfort and safety throughout.
Step 2: Positioning: Most cases are performed in the prone position, with supine access as an option.
Step 3: Retrograde Catheterization: A ureteric catheter is inserted to assist in contrast imaging of the urinary tract.
Step 4 : Percutaneous Access: A tiny skin incision allows insertion of a guidewire and sheath into the kidney.
Step 5: Stone Fragmentation: Miniature nephroscopes with laser or ultrasonic devices break the stones into pieces.
Step 6: Stone Retrieval: Stone fragments are cleared with suction or specialized baskets.
Step 7: Drainage: A temporary nephrostomy tube or DJ stent may be placed to support drainage, depending on the findings.

Before the Surgery: Patient Preparation

• Imaging: CT KUB or ultrasound helps assess stone size, density, and position.
• Laboratory Tests: Blood work and urine culture are checked for infections or metabolic issues.
• Medication Review: Anticoagulants and blood thinners are stopped prior to surgery as advised.
• Fasting: A fasting period of 6–8 hours before anaesthesia is required.
• Consent: Detailed discussion regarding procedure, alternatives, and possible complications is done with the patient.

During the Surgery: What Happens in MiniPerc

• Anaesthesia: Conducted under general anaesthesia for a painless and safe procedure.
• Patient Positioning: Generally performed prone; modifications are done as required.
• Retrograde Step: A catheter is inserted into the ureter to assist contrast-based guidance.
• Access Tract Creation: A fine needle punctures the kidney, followed by guidewire and sheath dilation.
• Stone Disintegration: Stones are visualized and fragmented using Holmium:YAG laser or ultrasonic lithotripsy.
• Drainage and Closure: Placement of a stent or nephrostomy tube may be done for smooth recovery.

After the Surgery: Post-Operative Care

• Hospital Stay: Discharge is usually within 24–48 hours.
• Monitoring: Urine output, pain, and any bleeding are observed.
• Pain Management: Minimal discomfort is managed with standard analgesics.
• Tube/Stent Care: If a stent or tube is placed, removal is scheduled in follow-up.
• Diet & Activity: Oral intake resumes the same day; light movement is encouraged by the next day.

Recovery Timeline

• Initial Recovery: Patients often return to light activity within 2–3 days.
• Complete Recovery: Full activity is usually possible within 1–2 weeks.
• Follow-Up: Imaging like ultrasound/X-ray is done to confirm stone clearance.
• Stent Removal: DJ stent, if used, is removed after 1–3 weeks.

Advantages of MiniPerc

• Smaller Tract: Minimizes kidney tissue injury and reduces bleeding risk.
• Less Pain: Fine instruments reduce postoperative discomfort.
• Better Cosmesis: Tiny incision results in negligible scarring.
• Faster Recovery: Patients resume normal activities sooner.
• Safe for Pediatric & Slim Patients: Ideal in children and lean adults.
• High Success: Effective for stones unsuitable for ESWL or RIRS.